The Learning Curve for Peroral Endoscopic Myotomy in Latin America: A Slide to the Right?

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorKAHALEH, Michel
dc.contributor.authorTYBERG, Amy
dc.contributor.authorSURESH, Supriya
dc.contributor.authorLAMBROZA, Arnon
dc.contributor.authorCASAS, Fernando Rodriguez
dc.contributor.authorREY, Mario
dc.contributor.authorNIETO, Jose
dc.contributor.authorMARTINEZ, Guadalupe Ma
dc.contributor.authorZAMARRIPA, Felipe
dc.contributor.authorARANTES, Vitor
dc.contributor.authorPORFILIO, Maria G.
dc.contributor.authorGAIDHANE, Monica
dc.contributor.authorFAMILIARI, Pietro
dc.contributor.authorCARAMES, Juan Carlos
dc.contributor.authorVARGAS-RUBIO, Romulo
dc.contributor.authorCANADAS, Raul
dc.contributor.authorHANI, Albis
dc.contributor.authorMUNOZ, Guillermo
dc.contributor.authorCASTILLO, Bismarck
dc.contributor.authorMOURA, Eduardo T.
dc.contributor.authorGALILEU, Farias F.
dc.contributor.authorLUKASHOK, Hannah P.
dc.contributor.authorROBLES-MEDRANDA, Carlos
dc.contributor.authorMOURA, Eduardo G. de
dc.date.accessioned2022-10-26T14:48:35Z
dc.date.available2022-10-26T14:48:35Z
dc.date.issued2021
dc.description.abstractBackground/Aims: Peroral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America. Methods: Patients undergoing POEM in Latin America with a single operator were included from a prospective registr y over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve. Results: A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients). The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressi v e l y decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01). Conclusions: Mastering POEM in Latin America requires approxima t e l y 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.eng
dc.description.indexPubMedeng
dc.identifier.citationCLINICAL ENDOSCOPY, v.54, n.5, p.701-705, 2021
dc.identifier.doi10.5946/ce.2020.290
dc.identifier.eissn2234-2443
dc.identifier.issn2234-2400
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/49535
dc.language.isoeng
dc.publisherKOREAN SOC GASTROINTESTINAL ENDOSCOPYeng
dc.relation.ispartofClinical Endoscopy
dc.rightsopenAccesseng
dc.rights.holderCopyright KOREAN SOC GASTROINTESTINAL ENDOSCOPYeng
dc.subjectAchalasiaeng
dc.subjectChagaseng
dc.subjectLatin Americaeng
dc.subjectLearning Curveeng
dc.subjectPer oral endoscopic myotomyeng
dc.subject.otherpoemeng
dc.subject.otherachalasiaeng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleThe Learning Curve for Peroral Endoscopic Myotomy in Latin America: A Slide to the Right?eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryColômbia
hcfmusp.affiliation.countryMéxico
hcfmusp.affiliation.countryArgentina
hcfmusp.affiliation.countryNicarágua
hcfmusp.affiliation.countryEquador
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisoco
hcfmusp.affiliation.countryisous
hcfmusp.affiliation.countryisomx
hcfmusp.affiliation.countryisoar
hcfmusp.affiliation.countryisoit
hcfmusp.affiliation.countryisoni
hcfmusp.affiliation.countryisoec
hcfmusp.author.externalKAHALEH, Michel:Robert Wood Johnson Univ Hosp, 1 RWJ Plaza,MEB 464, New Brunswick, NJ 08901 USA
hcfmusp.author.externalTYBERG, Amy:Robert Wood Johnson Univ Hosp, 1 RWJ Plaza,MEB 464, New Brunswick, NJ 08901 USA
hcfmusp.author.externalSURESH, Supriya:Weill Cornell Med Coll, New York, NY USA
hcfmusp.author.externalLAMBROZA, Arnon:Weill Cornell Med Coll, New York, NY USA
hcfmusp.author.externalCASAS, Fernando Rodriguez:Policia, Bogota, Colombia
hcfmusp.author.externalREY, Mario:Policia, Bogota, Colombia
hcfmusp.author.externalNIETO, Jose:Borland Groover, Jacksonville, FL USA
hcfmusp.author.externalMARTINEZ, Guadalupe Ma:Juarez Hosp, Mexico City, DF, Mexico
hcfmusp.author.externalZAMARRIPA, Felipe:Juarez Hosp, Mexico City, DF, Mexico
hcfmusp.author.externalARANTES, Vitor:Belo Horizonte Hosp, Belo Horizonte, MG, Brazil
hcfmusp.author.externalPORFILIO, Maria G.:Hosp Escuela Dr Ramon Madariaga, Posadas, Argentina
hcfmusp.author.externalGAIDHANE, Monica:Robert Wood Johnson Univ Hosp, 1 RWJ Plaza,MEB 464, New Brunswick, NJ 08901 USA
hcfmusp.author.externalFAMILIARI, Pietro:Gemelli Univ Hosp, Rome, Italy
hcfmusp.author.externalCARAMES, Juan Carlos:Santander Hosp, Reynosa, Mexico
hcfmusp.author.externalVARGAS-RUBIO, Romulo:San Ignacio Univ Hosp, Bogota, Colombia
hcfmusp.author.externalCANADAS, Raul:San Ignacio Univ Hosp, Bogota, Colombia
hcfmusp.author.externalHANI, Albis:San Ignacio Univ Hosp, Bogota, Colombia
hcfmusp.author.externalMUNOZ, Guillermo:Robert Wood Johnson Univ Hosp, 1 RWJ Plaza,MEB 464, New Brunswick, NJ 08901 USA
hcfmusp.author.externalCASTILLO, Bismarck:Gastromed Clin, Managua, Nicaragua
hcfmusp.author.externalGALILEU, Farias F.:Univ Sao Paulo, Gastrointestinal Endoscopy Unit, Sao Paulo, Brazil
hcfmusp.author.externalLUKASHOK, Hannah P.:Inst Ecuatoriano Enfermedades Digest, Guayaquil, Ecuador
hcfmusp.author.externalROBLES-MEDRANDA, Carlos:Inst Ecuatoriano Enfermedades Digest, Guayaquil, Ecuador
hcfmusp.citation.scopus3
hcfmusp.contributor.author-fmusphcEDUARDO TURIANI HOURNEAUX DE MOURA
hcfmusp.contributor.author-fmusphcEDUARDO GUIMARAES HOURNEAUX DE MOURA
hcfmusp.description.beginpage701
hcfmusp.description.endpage705
hcfmusp.description.issue5
hcfmusp.description.volume54
hcfmusp.origemWOS
hcfmusp.origem.pubmed34078028
hcfmusp.origem.scopus2-s2.0-85112414601
hcfmusp.origem.wosWOS:000706414500013
hcfmusp.publisher.citySEOULeng
hcfmusp.publisher.countrySOUTH KOREAeng
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